Delivering safe and effective test-result communication, management and follow-up: a mixed-methods study protocol

BMJ Open - Tập 8 Số 2 - Trang e020235 - 2018
Maria R. Dahm1, Andrew Georgiou1, Johanna Westbrook1, David Greenfield2, Andrea R. Horvath3,4, Denis Wakefield5,4, Ling Li1, Ken Hillman6,7, Patrick Bolton8, Anthony Scott Brown9,10, Graham Jones4,11, Robert Herkes12, Robert Lindeman13, Michael Legg14,15, Meredith Makeham16, Daniel Moses4,17, Dauda Badmus1, Craig Campbell1,3, Rae‐Anne Hardie1, Julie Li1, Euan J. McCaughey1,4,18, Gorkem Sezgin1, Judith Thomas1, Nasir Wabe1
1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
2Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
3Clinical Chemistry and Endocrinology, Prince of Wales Hospital, NSW Health Pathology, Sydney, New South Wales, Australia
4Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
5Centre for Immunology, NSW Health Pathology, Sydney, New South Wales, Australia
6Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
7The Simpson Centre for Health Services Research, SWS Clinical School, University of New South Wales, Kensington, New South Wales, Australia
8School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
9Health Consumers New South Wales, Sydney, New South Wales, Australia
10Men's Health Information and Resource Centre, Western Sydney University, Penrith, New South Wales, Australia
11SydPath, St Vincent's Hospital, Sydney, New South Wales, Australia
12Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
13NSW Health Pathology, Chatswood, New South Wales, Australia
14Faculty of Engineering & Information Science, University of Wollongong, Wollongong, New South Wales, Australia
15Michael Legg & Associates, Bulli, New South Wales, Australia
16Australian Digital Health Agency, Sydney, New South Wales, Australia
17Medical Imaging Department, Prince of Wales Hospital, Randwick, New South Wales, Australia
18Neuroscience Research Australia (NeuRA), University of New South Wales, Kensington, New South Wales, Australia

Tóm tắt

IntroductionThe failure to follow-up pathology and medical imaging test results poses patient-safety risks which threaten the effectiveness, quality and safety of patient care. The objective of this project is to: (1) improve the effectiveness and safety of test-result management through the establishment of clear governance processes of communication, responsibility and accountability; (2) harness health information technology (IT) to inform and monitor test-result management; (3) enhance the contribution of consumers to the establishment of safe and effective test-result management systems.Methods and analysisThis convergent mixed-methods project triangulates three multistage studies at seven adult hospitals and one paediatric hospital in Australia.Study 1 adopts qualitative research approaches including semistructured interviews, focus groups and ethnographic observations to gain a better understanding of test-result communication and management practices in hospitals, and to identify patient-safety risks which require quality-improvement interventions.Study 2 analyses linked sets of routinely collected healthcare data to examine critical test-result thresholds and test-result notification processes. A controlled before-and-after study across three emergency departments will measure the impact of interventions (including the use of IT) developed to improve the safety and quality of test-result communication and management processes.Study 3 adopts a consumer-driven approach, including semistructured interviews, and the convening of consumer-reference groups and community forums. The qualitative data will identify mechanisms to enhance the role of consumers in test-management governance processes, and inform the direction of the research and the interpretation of findings.Ethics and disseminationEthical approval has been granted by the South Eastern Sydney Local Health District Human Research Ethics Committee and Macquarie University. Findings will be disseminated in academic, industry and consumer journals, newsletters and conferences.

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BMJ Open

Tập 8 Số 2

e020235

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